Inspection on 25/07/06 for Woodbury House

This inspection was carried out on 25th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Woodbury House 19/08/08

Woodbury House 17/10/05

Woodbury House 17/05/05

Woodbury House 17/11/04

Woodbury House 07/05/04

Woodbury House 26/04/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Woodbury House Joulding Lane Farley Hill Swallowfield Berkshire RG7 1UR Lead Inspector Sandra Grainge Unannounced Inspection 25th July 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000011026.V294346.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000011026.V294346.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Woodbury House Address Joulding Lane Farley Hill Swallowfield Berkshire RG7 1UR 0118 9733885 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) the.willows@ashbourne.co.uk Exceler Healthcare Services Limited Post Vacant Care Home 45 Category(ies) of Dementia (12), Old age, not falling within any registration, with number other category (33) of places DS0000011026.V294346.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th October 2005 Brief Description of the Service: The property is a large converted country house that has rural views across the Berkshire countryside on the outskirts of Farley Hill near Reading. There is no public transport to the area; ample car parking spaces are available on the site and the service has its own transport vehicle. Woodbury House was part of the Ashbourne Healthcare Group; since the previous inspection in October 2005 the service has been sold; the operating company is Southern Cross Healthcare Group. A change to the registration of Woodbury House has been made; the service continues to provide personal care with nursing for up to 33 Older people and also residential care in a segregated unit on the first floor for up to 12 persons over the age of 50 years who have special needs including early dementia. Two weeks prior to the site visit the Registered Manager resigned from her position. Scale of charges as supplied 09.05.06 - range from £550-£ 825.00. Per week. DS0000011026.V294346.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report includes information gathered during an unannounced site visit to Woodberry House on a very hot weekday. Prior to the site visit the key inspection process included review of the service file, records and comments received from 6 Service Users in response to the CSCI “Have your say “ survey cards. These comments are included in the report in the appropriate outcomes. Data provided by the Registered Manager before she left also informed the report. Service User views were sought during the visit; very few were able to respond due to advanced age or illness. Fortunately the Inspector was able to speak to three relatives who were visiting and also to most staff on duty including the Care Manager, administrator, chef and maintenance employee. A tour was made of the House; care practice and interaction between staff and Service Users was observed and files were inspected. What the service does well: What has improved since the last inspection? DS0000011026.V294346.R01.S.doc Version 5.2 Page 6 The requirements of the previous inspection had been met; the acting Manager had applied and been registered as the Manager. Service Users reported that there was a better choice of enjoyable food. Staff were observed to address Service Users with politeness and treat them with respect and dignity, staff were very aware of Service User preferences. Bedrooms on the ground and first floors had been redecorated and major work had been carried out to repair one of the lifts; Service users were enjoying use of a new transport vehicle and staff reported that more training was now available to them with the new company. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. DS0000011026.V294346.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000011026.V294346.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5 Quality in this outcome area is good. Service Users and their representatives have the information that they need to choose a home that meets their needs. Their needs are assessed and they have a contract for the service that is offered. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Company produces a comprehensive Statement of Purpose for prospective Service Users. The acting manger had recently visited a Service User in hospital to assess her needs and was in the process of discussing with a local authority care manager the service’s capacity to meet the needs that had been identified. Each Service User file contained evidence of comprehensive assessment and terms and conditions for care service. Only a few Service Users were able to comment on their experience of the process of admission to the service. Three relatives considered that the information supplied by the home had enabled them to make informed choice and the same message was contained in the returned survey forms. One DS0000011026.V294346.R01.S.doc Version 5.2 Page 9 relative commented that her Mother had found that the trial visit was particularly helpful because staff had taken time to explain things to her. DS0000011026.V294346.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. The health and personal care given to meet assessed individual needs of those receiving nursing care continues to be comprehensive. The service is still being established in the new unit. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service Users in the unit on the first floor had their own combined lounge and dining room within the keypad bounded area. Although they are mobile they did not have access to the attractive grounds or other communal areas in the building. There was only one member of staff working with them. All had care plans to meet assessed individual health and personal care needs. Files for those recently admitted to the new unit for residential care did not plan for care when the Service User’s needs altered. Staff were not aware of arrangements for provision of care for severe dementia needs and some were concerned that they did not have the skill to do this. No Service Users were able to be responsible for the administration of their own medication. The service had procedure and facilities for when selfmedication is appropriate. Staff work to the medication policy and procedures of the service. The clinical room for storage of medication trolleys and nursing equipment is now enclosed in the boundary of the new unit on the first floor; the impact of this is to be assessed. DS0000011026.V294346.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is adequate; the judgement is influenced by the operation of the new unit. Service Users receiving nursing care reported that they were pleased with provision made for them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service Users in all areas have activities organised for them. Those receiving nursing care can also enjoy use of the grounds and cooler areas of the house. Service Users who occupy the new unit were not able to comment on how they felt about being restricted to one area of the home; their behaviour was restless and agitated as expected of this client group. A relative of a previous occupant of the first floor commented that she thought the unit area was restrictive. The unit is not yet fully operational. There was only one member of staff based there; this restricted Service User choice of leaving the unit to go outside or to choose the gender of the member of staff able to offer personal care support. Service User meetings are held and recorded; they had requested a more varied menu and there was evidence that the service had responded to this request. Survey forms contained confirmation of this. The chef was a visible presence in the home; she routinely seeks Service User views and discusses need with staff. During the hot weather cold drinks were available and staff were observed to offer these frequently. Fluid record charts were kept for those who were at risk of dehydration. DS0000011026.V294346.R01.S.doc Version 5.2 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18 Quality in this outcome area is good. Service Users and their relatives knew how to make a complaint if necessary. Arrangements for protection of vulnerable adults were in place though the operational practice needed review the new unit. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All service Users had been informed of the complaint procedure. Visiting relatives were aware of the action that they could take if they were had concerns and they were certain that they would be listened to by staff who would take appropriate action. The same reply was made in the surveys. No complaints had been received by CSCI since the last inspection; the home had received three that had been successfully concluded. At the time of the visit a multi disciplinary investigation was in progress concerning an allegation of physical abuse to a Service User. The acting manager had notified the appropriate authorities and was working with them. Staff had revived training for awareness of abuse and action to be taken for the protection of vulnerable adults. Regrettably, the good practice intentions could be compromised because a single member of staff was working alone in the secure unit. DS0000011026.V294346.R01.S.doc Version 5.2 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 26 Quality in this outcome area is adequate; the establishment of the new unit has had a detrimental effect. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service Users live in a well-maintained environment. Bedrooms had been decorated as part of a programme of redecoration. Service Users were pleased that the new company had carried out a major repair to one of the lifts that had been faulty for a long time. Records of routine testing and maintenance were kept. During the visit the maintenance employee attended safety training for the use of bedrails. Service Users found the home comfortable and attractive. All areas visited were clean and tidy. The gardens are spacious with areas of seating and shade; there was no safe fenced area where those with confusion could wander without risk of getting lost. Service Users occupying the unrestricted areas of the first floor and receiving nursing care now have to pass through a keypad controlled area in order to DS0000011026.V294346.R01.S.doc Version 5.2 Page 14 use the assisted bath that is provided on the first floor. This means that they are not able to have a bath without seeking assistance. DS0000011026.V294346.R01.S.doc Version 5.2 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate because of the impact of the new unit where the service is not yet fully operational. Service Users receiving nursing care were pleased with the care given by sufficient numbers of skilled staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service Users’ need in the new unit was not met because only one member of staff was working there. This gave no opportunity for Service Users to have choice of the gender of the carer who offered them personal care support and the member of staff could not leave the unit to escort them to the garden or other cooler parts of the building. Service Users were protected by the robust well-recorded staff recruitment procedures of the company. Staff were trained to provide personal and nursing care and there was an established training programme in operation. Additional training had been planned for those who work to meet the dementia needs of Service Users in the new unit. Staff were concerned that only two people had so far received additional dementia care training. DS0000011026.V294346.R01.S.doc Version 5.2 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33, 37 and, 38 Quality in this outcome area is good. The company procedures are in place and staff were working hard to follow these without the leadership of a registered manager. The previous good standards of record keeping, financial management and staff supervision were continuing. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service was without a Registered Manager. The care manager was acting up to be in charge of the home; the company area Manager was on call and visited twice a week to give support. A relative wished that she had been officially informed about the Registered Manager’s resignation and the company’s interim management arrangements. There was evidence that Service Users were living in a well-managed safe environment. They were protected by staff who were adhering to the company record keeping and financial management procedures. DS0000011026.V294346.R01.S.doc Version 5.2 Page 17 Routine management protection of the health, safety and welfare of Service Users was continuing. This was demonstrated during the visit as a specialist company serviced the fire safety equipment. Company quality assurance monitoring systems are in use; reports are sent to CSCI and the requirements of regulation have been met. DS0000011026.V294346.R01.S.doc Version 5.2 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 2 3 2 2 X X X X 3 STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X X 3 3 DS0000011026.V294346.R01.S.doc Version 5.2 Page 19 Are there any outstanding requirements from the last inspection? Yes in that again the service does not have a Registered Manager due to the recent resignation of the post holder. All other previous requirements have been met. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP31 Regulation 9(1)(2)b Requirement The Responsible Individual is required to provide a plan to demonstrate satisfactory management of the service until a new Manager is recruited and Registered. Timescale for action 05/09/06 OP27 2 18(1)a The Responsible Individual is required to deploy sufficient numbers of trained staff to work in the residential unit to allow Service Users to have safe access to the garden and other areas of the building and to give choice of carer for personal care support. 15/08/06 DS0000011026.V294346.R01.S.doc Version 5.2 Page 20 OP3 3 15; schedule 3 The responsible Individual must ensure that Service Users admitted to the new unit have assessed needs that are in accordance with the service Statement of Purpose and a plan must be in place for action to be taken when Service User assessed needs change. The Responsible Individual must send a plan to show the arrangements made to allow Service Users who receive nursing care on the first floor to have access to an assisted bath. The Responsible Individual must assess the impact on nursing practice caused by restricted access to the clinical room and plan to eliminate identified problems 05/09/06 OP21 4 23(2)j 05/09/06 5 OP22 13 (2) 23 (1) a 05/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP31 Good Practice Recommendations It is recommended that the Registered Person write to Service Users and their next of kin to inform them of the resignation of the Registered Manager and give them detail of the management arrangements in place until the registration of a new manager. DS0000011026.V294346.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI DS0000011026.V294346.R01.S.doc Version 5.2 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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